Fig. 100.—(1) Orthognathous face; (2) prognathism limited to the nasal region; (3) prognathism limited to the subnasal region; (4) total prognathism, including the three regions, supra-nasal, nasal and subnasal; (5) exaggerated total prognathism, accompanied by mandibular prognathism; (6) the same in a child; (7) very marked prognathism, but due entirely to the prominence of the supra-nasal section, resulting in an apparent orthognathism (male of tall stature); (8) opposite type to the preceding: pronounced prognathism not extending to the supra-nasal region (feminine type); (9) misunderstood Greek profile (incorrect) resulting in a notable prognathism; (10) correct Greek profile, i.e., conforming to that of Greek statues, and incompatible with prognathism.[41]

Manouvrier, analysing the forms of prognathism from the point of view of physiognomy and cerebral development, notes that varieties 4 and 5 seem to him to correspond to a more or less serious cerebral development; variety 2, very frequent in France and more particularly, according to the author, among the Jews, is not incompatible with a high cerebral inferiority. Variety 3, more frequent in the feminine sex, is found in conjunction, sometimes with a weakly skeletal system, and frequently with rickets and cretinism; nevertheless, Beethoven showed an approach to this profile.

Variety 4 indicates on the contrary an extremely vigorous development of the skeleton, with the qualities and defects commonly associated with great physical strength; variety 7 is regularly associated with tall stature; in fact, in this case the prognathism is determined by excessive development of the frontal bone-sockets.

It is this development, prevalent in the male sex, that renders subnasal prognathism much rarer in man. As a matter of fact, the feminine type of prognathism shown in No. 8 is not greater in degree than the male type, No. 7. Variety 9 shows us a form of prognathism in art, due to a false interpretation of the Greek profile; it is commonly believed that in the Greek profile the frontal line is a continuation of that along the bridge of the nose, and hence we frequently meet with commemorative medals, etc., bearing the monstrous profile shown in No. 9, with pronounced prognathism and receding forehead. The true Greek profile is shown in No. 10, but we can better analyse it by studying the profile of the Discobolus (Fig. 105) and of Antinoous (Fig. 106).

Fig. 101.

Fig. 102.—Head of Pauline Bonaparte Borghese (Rome, Borghese Museum).

Fig. 103.—Profiles of microcephalics.

The lines of the facial angle have been traced upon the profile of the Discobolus, but the profile of Antinoous has been left untouched, in order that we may trace the same lines upon it in imagination, and thus judge of its perfect beauty (facing page (270)).

Let us first examine these two Greek profiles, without stopping to analyse their separate characteristics, but considering them from the more general point of view of the facial profile in general. Reverting, instead, for our analytical study to the schematic figure shown in Fig. 104, we see that it also shows the line of the facial profile, that of orientation and the vertical, and that these lines form certain right-angled triangles; the right angle MPA is not the facial angle, any more than the corresponding angle shown in the Discobolus is the facial angle. It is said that Greek art considered the right angle as the perfect facial angle; but that is not true. In order to obtain the facial angle it is necessary to draw a third line (MS) which extends from the metopic point to the point of attachment of the nasal septum to the upper lip; this is the line of the facial profile, and the angle MSA is the facial angle. It is never a right angle (see the Discobolus), but it approaches very closely to a right angle. Let us examine the triangle MPS, bounded by the vertical, the line of profile and the line of orientation; it is right-angled at P. Hence, the sum of its other two angles must be equal to one right angle; but the upper angle, corresponding to the nasal aperture, is of only 15°, and consequently the facial angle is 75°. The facial angle of the Discobolus also, like that of Antinoous, like that of the normal human visage, is 75°.

Fig. 104.

Examine further this Fig. 104; in it the line of the facial profile, extending from the metopion to the septo-labial point also passes through the point corresponding to the attachment of the base of the nose (nasion).

The figure is schematic; but anyone who will trace it in imagination upon the profile of Cavalieri, or on that of the seated woman in the group of Neopolitan peasants, or on any of the classic profiles known in art as the Roman profile, will find that the nasal line, connecting the supra- and subnasal points, coincides with the line drawn from the subnasal point to the metopion. But if we observe the Greek profile of the Discobolus, we shall find that the line of profile does not coincide with the base of the nose, but passes behind it.

This is the real characteristic difference between the Roman and the Greek profile: in the Greek profile, the root of the nose is attached further in front of the metopico-subnasal line, and this is due to the special form of the Greek forehead, which, instead of being slightly flattened at the glabella, as in the equally beautiful Roman forehead, is rounded to such a degree that the transverse section of the forehead follows a circular line. Hence, it results that the metopic region of the forehead is more prominent and the nose straight, and hence also the line of the forehead is a perceptible continuation of that of the nose (compare the Antinoous). This unique and essential difference between the Greek and the Roman profile has not hitherto been pointed out, so far as I am aware; it is indicated by just one of the facial lines, the one which forms an angle of 75° with the line of orientation. I had an opportunity to observe these differences in my study of the women of Latium, which I pursued side by side with a study of the statues in the museums of Rome, under the guidance of distinguished art specialists; nevertheless, they had none of them ever defined by mathematical lines the sole difference between the two classic types.

The habit of tracing these imaginary lines renders us far more keen in recognising any and every degree of prognathism, even the least perceptible, and any other imperfection of the profile, than the most complicated system of goniometry would make us. For instance, examine the profile of Pauline Borghese; it is certainly not prognathous, since the vertical line reveals a most impeccable orthognathism. But let us trace the nasal line: it meets the vertical line before reaching the metopic point; in order to meet it at this point, the nose would have had to be narrower from front to back; in that case the profile of Pauline Borghese would have been a perfect Roman profile; but the imperial stigma of the Napoleonic house deprived the beautiful princess of the privilege of perfect classic beauty.

In my studies of the women of Latium, in addition to the Greek and Roman forms of profile which are very frequent (the former distinguished by the morphological peculiarity of having no definite naso-frontal angle nor metopic flattening of the forehead) I found a third profile, less frequent yet quite characteristic, among the representatives of the Mediterranean (Eurafrican) race. It is worthy of note (Figs. 107, 108).

First of all, the forehead has a slight transverse depression along its middle line, and the mandible is slightly elongated; but if we draw our imaginary vertical line from the extreme forward point of the brow, we find that none of the forms of prognathism is involved, and that the auriculo-subnasal line is horizontal. This is the type that has been described by Sergi as Egyptian; and the young woman, shown in profile, really does suggest a reincarnation of the proud beauty of the daughters of Pharaoh; the somewhat fleshy lips and the form of the eyes, not almond-like, but very wide and horizontal, complete the characteristics of the type immortalised in Egyptian art.

In the normal profile two forms can be distinguished which are associated with the two general forms of leptoprosopic and chameprosopic face, and hence also with the dolichocephalic and brachycephalic forms of cranium. In the one case, the features are more elongated and seem to be more depressed laterally, with the result that the profile is more refined, the visage narrower, along the longitudinal line; in this case the profile is proopic (as, for example, in the aforesaid Egyptian profile and in the elongated ovoidal English face, Fig. 90); aristocratic faces of the finer type are proopic. On the other hand, broad faces are anteriorly flattened to such an extent that the flatness shows even in the profile: platyopic profile.

Fig. 105.—The Discobolus by Miron (Rome, Vatican Museum).

Fig. 106.—Head of statue known as the Capitoline Antinoous (Rome, Capitoline Museum).

Fig. 107.

Fig. 108.

These general forms are associated with certain special forms of the separate organs.

Thus, for example, in proopic faces the palate is narrow, long and high; in platyopic faces, on the contrary, it is broad, low and flat; and the teeth corresponding to them may present a widely different appearance (long, narrow teeth; broad teeth).

Low Types and Abnormal Forms.—Low types, as we have already noted, depend upon the development of the face in its least noble parts (those of mastication); prominence of the cheek-bones and maxillary angles, great development of the upper and lower jaw (prognathism). These conditions are frequently accompanied by a low, narrow, or receding forehead, indicating a scanty cerebral development. Lombroso found a great prevalence of similar forms among criminals; but recent studies have disclosed the fact that such forms of facial development are in some way related to the environment in which the individual has developed, so much so that, on the basis of these morphological characteristics, we might almost succeed in delineating the physiognomies distinguishing the different social castes. In fact, while the aristocratic face is ellipsoidal and proopic, that of the peasant is characterised by a pronounced wideness between the cheek-bones, and that of the city labourer by a peculiar development in the height of the mandible. Thus the peasant has a broad face, and the city workman a somewhat elongated face, with very pronounced maxillary angles.

A real and important abnormality which indicates a deviation from every type of race or caste is facial asymmetry or plagioprosopy, analogous to plagiocephaly, and frequently associated with it.

It is necessary, however, in the case of the face, to distinguish instances of functional asymmetry, due to unequal innervation of the muscles in the two sides of the face; either from some cerebral cause, or from some local cause affecting the facial nerves. In such cases, the trophic state of the muscles and their contractibility being unequal, there is a resultant asymmetry, especially evident in the play of facial expression.

This form of asymmetry must necessarily be limited to the soft tissues and be due to a pathological cause; consequently it should not be confounded with the asymmetry due to a different skeletal development of the two sides of the face, an abnormality analogous to plagiocephaly, which is met with among degenerates as a stigma of congenital malformation. We owe to Brugia a most admirable method for demonstrating the high degrees of facial asymmetry which sometimes reach such an extreme point as to give the two halves the appearance of having formed parts of two different faces. This is precisely what Brugia shows by the aid of photography, uniting each half with a reversed print of itself, making the two prints coincide along the median line. The result is that every asymmetric face gives two other faces formed respectively from one of the two inequal halves, and presenting profoundly different aspects.

Other abnormalities are revealed by the facial profile. They are due either to total or partial prognathism (already analysed), or to orthognathism, where the facial angle equals or exceeds a right angle; such a profile occurs in cases of hydrocephaly or of macrocephaly in general, usually resulting from infantile arrest of development.

The Evolution of the Face.—The human countenance, that is so marvellously beautiful in our superior hybrid races, passes, during its embryonal life, through many forms that are very far removed from such perfection.

Figures 110, 111, and 112 represent the evolution of the face in animals and in man: and the complete evolution of a woman's face from the embryo during the first weeks of its formation to the attainment of old age.

The embryonal face, as may be seen even better in animals than in man, is surmounted by the brain divided and differentiated into its superimposed primitive vesicles; furthermore, it consists of one single, widespread cavity, at the sides of which may be discerned two diminutive vesicles or bulbs, which are offshoots of the brain and constitute the first rudiments of the eyes. In studying a more advanced stage of development, we may note in what constitutes the upper lip of this wide facial cavity, two nasal ducts or furrows, which are the first indications of the nose.

The principal differentiation which takes place in the face consists of the development from its two lateral walls on left and right, of two thin plates or laminæ that advance across the cavity itself, in its anterior portion, and proceed to unite in a median ridge, the raphe palati; this constitutes the formation of the palatine vault, which is destined permanently to divide the single cavity into two cavities—an upper or nasal, and a lower or buccal cavity. If this process of formation is not completed, the result is a grave abnormality, the cleft palate, popularly known in Italy as a "wolf's throat," and consisting in the fact that the nasal and buccal cavities to a greater or less extent open into each other; this abnormality, due to an arrest of embryonic development, is almost always accompanied by a hare-lip.

Simultaneously with the formation of the palatine vault, another and vertical septum is formed, which divides the upper cavity into two halves, right and left. This division, however, is limited to the anterior portion; the three cavities thus formed have no such division in the rear, but all three open into the gullet or œsophagus, which represents the only relic of the single original cavity.

The maxillary bones are formed in a manner analogous to that of the nasal and palatal septa, through extroversions destined to become ossified.

It is not until later that the external nose is formed (middle of the second month of embryonal life).

After this, the evolution of the embryo becomes evidently a perfectionment and a growth, rather than a transformation.

In the new-born child the face is extremely small in comparison with the cerebral cranium.

If we compare the head of an adult with that of an infant, and draw the well-known line of separation between the facial and the cerebral cranium, the difference in the reciprocal proportions between the two parts at once becomes apparent. The infant's face seems like a mere appendix to its cranium; and the mandible is especially small; in fact, very young children remain much of the time with their mouth open and the under lip drawn back behind the upper.

Fig. 109.—Face of inferior type. Prominence of angles of jaw (Gonia).

Fig. 110.

Fig. 111.               Fig. 112.

a, eye; v, anterior brain; m, middle brain; s, frontal process; h, nasal septum; o, u, h, d, r, primitive embryonal formations, explained as being branchial (i.e., gill) arches; z, tongue; g, auditory fissure. Note the analogy between the different parts of the head in animals and in man; every species, however, has special embryonal characteristics.

Consequently, the growth of the face obeys laws and rhythms differing from those of the cranium, in comparison to which the face is destined to assume very different proportions by the time that the adult age is reached. The face grows much more than the cranium.

In its characteristic infantile form, the face is quite round (short and broad), and, when the child is plump, it often happens that at birth the face is broader than it is long. Seen in profile it is orthognathous, and this orthognathism endures throughout early infancy, because the profile still remains in retreat behind the plane of the protruding forehead; i.e., the facial angle exceeds a right angle, and the mandibular region is further back than the nasal (compare profile of infant).

In the course of growth it may be said in a general way that the facial index diminishes; that is, the numerical proportion between width and height becomes lowered as the face lengthens; while the facial angle changes from somewhat more than a right angle to a right angle, and finally to an acute angle of 75°.

In order to obtain an exact idea of the transformations of the face, children should have their pictures taken, full face and profile, on every birthday, as is already customary in England for the purposes of the carnet maternel, the "mother's note-book."

In the illustrations facing this page we have portraits of the same person taken at successive ages (Figs. 113, 114, 115, 116), i.e., at the age of six months, one year and a half, seven, and lastly twelve years; it will be seen that the face has steadily lengthened.

In this case the individual happens to be noticeably leptoprosopic; but observe the rotundity of the infantile face at the age of six months.

An analogous observation may be made in the case of the girl represented in Figs. 118 and 119, at the age of ten months and thirteen years respectively.

Even in the case of abnormal children the same law holds good; an examination of the three pictures of an incurable idiot boy, taken at the ages of six, eleven, and sixteen years (Figs. 121, 122, 123 facing page (276)), shows that the face, from being originally rotund has become elongated.[42]

We owe to Binet the most exact and complete studies that exist in anthropologic literature on the subject of the growth of the face. He has made a great number of facial measurements, both of children and young persons of the male sex, from four to eighteen years of age, taking the measurements at intervals of two years. The measurements chosen by Binet are all the possible distances that will serve to give the various widths of the face, the distance of the ear from the various points of the profile, and the heights of the various segments; namely (for an exact understanding of these measurements, see section on Technique), auriculo-mental diameter, auriculo-nasal diameter, auriculo-subnasal diameter, auriculo-ophryac diameter, auriculo-metopic diameter, frontal diameter, biauricular diameter, bizygomatic diameter, length of nose, length of chin, subnase-mental distance, height of forehead.[43]

Binet's conclusions are as follows: the growth of the whole head may be divided into three rhythms: that of the cerebral cranium, that of the face apart from the nose, and that of the nose.

If the total development of the cerebral cranium from the fourth to the eighteenth year shows a proportion of 12 per cent., the facial development shows an increase of 24 per cent. and that of the nose 39 per cent. Consequently the face increases twice as much as the cranium, and the nose three times as much. In the growth of the face, however, the transverse dimensions must be distinguished from the longitudinal dimensions, because the facial index varies greatly according to the age. The width of the face follows very nearly the same rhythm as the cranium, never exceeding the latter's proportional increase; the length of the face, on the contrary, follows the special rhythm of the growth of the face, which lengthens far more than it broadens.

If we consider the distances of the various points in the profile from the auricular foramen, we find that these distances show a greater increase in proportion as the points in question are further from the forehead and nearer to the chin.

The central section (the nose) and the mandible are the portions which contribute most largely to the increase in length of the face.

While in the case of the cranium there is a very slight, and often imperceptible puberal acceleration of growth, the puberal transformations of the head are, on the contrary, most notable in respect to the face.

The entire region of the upper and lower jaws, but more especially the lower, undergoes a maximum increase during the period of puberty.

In regard to the nose, its rapid growth begins at the time immediately preceding puberty; that is, it undergoes a prepuberal maximum increase. When a boy is about to complete his sexual development, the nose begins to gain in size.

The puberal growth of the mandible has long been a familiar fact, and bears a relation to the development of the sexual glands.

A special characteristic noted by Binet and by myself is that the height of the lower jaw in boys who have reached the prepuberal stage is greater in the boys who are least intelligent; just as in the case of these boys the nose is less leptorrhine and the face less broad. This means that at the period of puberty the most intelligent boys not only have a greater development of head, but also certain distinctive facial characteristics. They should have, for instance, a more ample forehead, a broader face, especially in the bizygomatic diameter (between the cheek-bones), and a leptorrhine nose (infantile leptorrhine type). The backward boys, on the contrary, have a longer face, accompanied by a higher mandible and a flat or "snub" nose. Here are the comparative figures:

Fig. 113.—A child at six months.

Fig. 114.—The same child at a year and a half.

Fig. 115.—A seven-year-old boy.

Fig. 116.—The same boy at the age of twelve.

FACIAL MEASUREMENTS

Binet Children from the elementary schools of Paris from 11 to 13 years of age
Montessori Children from the elementary schools of Rome from 9 to 11 years of age

COMPARATIVE FACIAL MEASUREMENTS OBTAINED FROM THE BRIGHTEST AND THE MOST BACKWARD PUPILS IN THE SCHOOLS OF ROME (MONTESSORI)

These results would seem to prove that there are high and low infantile types of face, analogous, let us say, to types of social caste; and in school life they correspond to the castes of the intelligent and the backward pupils.

Intelligent children tend to preserve the infantile form of face more intact (broad and short) or rather, if we extend our researches to pupils who have reached the prepuberal age, we may conclude that intelligent pupils develop according to the normal laws—the growth is confined to the nose; backward children invert the order of growth—the lower jaw is already enlarged before the nose has even begun the acceleration of puberal growth. This difference remains permanent in the adult, and we have in consequence low types of face characterised by a flat nose and heavy lower jaw.

Facial Expression.—The study of the human face cannot be limited to a consideration of the form alone; because what gives character to it is the expression. Internal thought, sensory impressions and all the various emotions produce responsive movements of the facial muscles, whose contractions determine those visible phenomena corresponding to the inner state of mind.

The teacher ought to understand facial expression, just as a physician must train himself to recognise the facies corresponding to various diseases and states of suffering. The study of expression ought to form a part of the study of psychology, but it also comes within the province of anthropology, because the habitual, life-long expressions of the face determine the wrinkles of old age, which are distinctly an anthropological characteristic.

The facial muscles may be divided into two zones: one of which comprises the frontal and ocular region, and the other the buccal region; corresponding to which are the two upper and lower branches of the frontal nerve.

Accordingly we may speak of a frontal or higher zone of expression and of an oral or lower zone.

The expressions of pure thought (attention, reflection) group themselves around the forehead; those of emotion, on the contrary, call forth a combined action of both zones, and frequently irradiate over the entire body. But as a general rule the man of higher intelligence has a greater intensity of frontal expression, and the man of low intelligence (uneducated men, peasants, and to a much greater degree, imbeciles, idiots, etc.) have a predominance of oral expression.

In children the frontal zone has slight mobility, and the oral zone has a preponderance of expression; infantile expression, however, is diffuse and exaggerated and is characterised by grimaces. Undoubtedly there are certain restraining powers, which develop in the course of time and serve to limit and definitely determine the facial expressions.

Fig. 117.—Profile of a child.

Fig.—118. A child of ten months.

Fig. 119.—The same, 13 years old.

Fig. 120.—The Muscles of the Head and Face.

Here are a few of the principal facial expressions, described in a masterly manner, and for the first time, by Charles Darwin:[44]

Expression of Sorrow.—The muscles that are principally brought into play are the superciliary, the frontal and the triangular or depressor muscles of the lips; the eyebrows are furrowed, being drawn upward by the action of the frontal muscle; this, however, cannot contract completely because drawn downward laterally by the superciliary muscles, and hence the forehead wrinkles only at its middle point and together with the slanting eyebrows assumes a shape that suggests three sides of a quadrilateral.

Fig. 121.—A six-year-old boy.

Fig. 122.—The same, eleven years old.

Fig. 123.—The same, sixteen years old.

Simultaneously there is a drooping of the corners of the mouth, which, when exaggerated in infancy, forms the characteristic and charming grimace of a child who is on the point of crying. Accordingly, sorrow draws the frontal zone upward, and the labial zone downward; in other words, it lengthens the face.

Expression of Pleasure.—On the contrary, laughter and happiness shorten the face; all the muscles are brought into play that stretch the corners of the mouth, as well as those which raise the upper lip, in consequence of which the upper teeth are disclosed.

The frontal zone remains in repose; excepting that there is a contraction of the orbicular muscle of the eyelids, especially in its lower portion; the lower lid is drawn upward and the skin is puckered at the external angle of the eye; the lachrymal gland is compressed, the circulation of blood stimulated, as always results from every expression of joy, the secretion of the gland is increased, and consequently a few tears are readily shed. The eye, grown smaller and half hidden, shines brilliantly, because moistened from without and irrigated from within by an abundant flow of blood.

Expression of Various Emotions: Anger.—During anger the superciliary muscles prevail in exceedingly energetic action, drawing the forehead strongly downward, wrinkling it vertically, and also producing transverse wrinkles on the nose. In the labial zone the orbicular muscle is intensely active, and the lips contract. When anger endures for a long time, the condition above described diminishes in intensity, leaving only a slight frown, while the closed lips protrude in tubular form. An expression usually described by the terms, to sulk or pout.

This is the way in which little children express their displeasure; and the pouting lips sometimes rise clear to the tip of the little nose, in sign of proud defiance. This form of grimace is common to the children of every race: it has been observed in the children of Hottentots and Chinese, as a sign of prolonged anger and ill humor.

Hence the contraction of the mouth is a characteristic sign of anger; and when the emotion is very strong, even the masticatory muscles may enter into play, causing a grinding of the teeth.

Surprise.—In surprise, on the contrary, the entire labial zone is in repose, and there is complete and free contraction of one muscle alone, the frontal; consequently it produces longitudinal lines across the entire forehead, uplifting the eyebrows, which passively follow the elevation produced by the frontal muscle, forming two arches around which the wrinkles of the forehead form themselves in parallel lines. The eyes in consequence are stretched to their widest. The oral zone is so far relaxed that the lower jaw droops in obedience to gravity and the mouth gapes open: bouche béanie. Sometimes a less intense degree of surprise fails to do away with the contraction of the orbicular muscle of the lips, which, without being actively contracted, but simply because relieved from the interference of antagonistic muscles, closes the mouth in a rounded or tubular aperture.

This same facial expression, which is a very striking one, exists in all races.

When children are still too young to contract the frontal muscle completely, they show surprise by a gaping mouth, and a puckering of the entire forehead, in place of the transverse furrows.

Expression of Thought.—In addition to the expressions of the emotions, the authorities describe those due to thought, and give special consideration to the expression of external or sensory attention, and internal attention (reflection, meditation). The young child is capable of intense sensorial attention, which is manifested especially in visual attention.

I have been able to make many observations in the "Children's Houses," where children two or three years old take part in games that demand attention, comparison, and the exercise of reason, without tiring their minds or encountering any great difficulty. These children wrinkle their foreheads and hold their mouths slightly open.

This is the expression also noted by Darwin, and the one which notoriously produces those vertical lines in the middle of the forehead, known as the lines of thought.

When these children are obliged to make an effort of thought or when they are for any reason troubled and anxious, slight contractions pass across their foreheads, like a continuous succession of broken shadows (Darwin).[45]

It should be noted that in any case a contraction of the eyebrows during intellectual work denotes effort, a difficulty to be overcome. Pure thought, by itself alone, produces no such contractions.

The contemplative man, absorbed in profound meditation, shows a face overspread with serenity, due to muscular repose; the gaze is fixed upon the void, and the head, as though no longer sustained by the relaxed muscles, is inclined forward.

If his eyes retain steadfastly the same original direction, even after the body has dropped forward, they give the impression of being turned on high. Such is the expression of the man sunk in profound thought, so long as his thought follows an uninterrupted course.

But when a difficulty arises, see how he begins to knit his brow. It is the difficulty which has arisen, and not the course of his thoughts, that has produced this muscular reaction.

The movement is similar to what occurs in the case of any difficulty to overcome, as, for instance, the threading of a needle.

Consequently the wrinkles of thought are the wrinkles of the fatigue of thought.

The mystics, who are purely contemplative thinkers, and not solvers of difficulties, have a forehead without lines. Similarly in art, the faces of the Madonna or of the Saints have an intense expression of thought in their gaze, but the serene countenance shows neither contractions nor lines.

De Sanctis[46] has made some interesting observations regarding the facial expression of the mentally deficient. They have a singular difficulty in contracting the frontal muscle even at the age of eleven or twelve years; even when urged by example and command, they frequently do not succeed in contracting the forehead. Labial expression, on the other hand, is much more developed, and frequently attention is indicated by a contraction of the orbicular muscle of the lips into a circle; and surprise is shown in the same way.

In general, however, what characterises the face of the imbecile, the idiot, the epileptic, is its immobility: hypomimia or amimia.

There are, however, frequent cases of cerebrophlegia (a progressive malady of the brain occurring during the early years of childhood), in which exaggerated contractions of the face occur as the result of the least mental effort. The French give the name of grimaciers to children who show such symptoms; from pathological causes they exhibit a hypermimia that transforms their facial expressions into grimaces. Furthermore, there are certain degenerate children in whom the muscular reactions do not correspond to the normal expression of their feelings; for example, they exhibit sorrow when they mean to show attention, etc. In such cases the play of the opposite and contradictory facial muscles has become perverted: dismimia.

One of the most frequent occurrences among the abnormal is asymmetry of the facial expressions; the muscles contract more on one side of the face than on the other. This symptom, however, in a mild degree, is met with also in normal persons.

From what has been said, it is evident that for the examination of the face we must depend, if not exclusively, at least far more upon anthroposcopy than upon anthropometry; and since the minute description required is too difficult and too lengthy a task, especially as regards the facial expressions (which are so characteristic of the individual) it is necessary in pedagogic anthropology to resort to photography.

The instantaneous photograph, in all progressive countries, is already within the reach of mothers. It ought also to form part of the equipment of our schools.

The Neck

The neck is a part which is anatomically of much importance, but not of equal importance from the anthropological side. The skeleton of the neck is formed of the seven cervical vertebræ. Notwithstanding that in all the higher vertebrates the neck is constituted of the same number of vertebræ, it can assume the most varied dimensions, all the way from the giraffe to the whale. Similarly, at the different ages of man it is at one time barely indicated and almost wanting altogether, as in the new-born child, and again long and flexible, as in the lovely women of some of the higher races.

Godin has observed that the maximum increase of the neck takes place between the fourteenth and sixteenth year, i.e., at the epoch of puberty; but at the fourteenth year it undergoes such a rapid increase that it surpasses proportionally the puberal increase of the total stature.

This is shown in the following table:

PROPORTION OF LENGTH OF NECK TO THE STATURE REDUCED TO 100

Consequently the proportion between neck and stature is a datum that tends strongly to remain a fixed quantity. The result, however, is different if we study the proportion between the neck and the vertebral column as a whole.

PROPORTION OF LENGTH OF NECK TO THE TRUNK REDUCED TO 100

Accordingly it is about one-third of the trunk.

The circumference of the neck is also taken, for it shows whether the neck is slender or thick; and this often bears a relation to the degree of development of the thyroid gland.

In my work upon the women of Latium I have shown that the small, dark women have a longer and more flexible neck than those who are fair and of tall stature. Therefore this is a racial difference, similar to the difference we have already noted for types of stature. The macrosceles have a long and slender neck, and the opposite is found in the case of the brachysceles; consequently, a very long neck is an indication of a weak constitution.

CHAPTER III
THE THORAX

We have already had occasion to point out, in connection with the types of stature, the importance of the thorax.

The relation of the thoracic perimeter (circumference of the chest) to the total stature (see chapter on Technique) was called by Goldstein the index of life, in order to indicate that the organic resistance of any individual depends upon the proportional relation between the thorax and the whole body; whoever has a narrow chest is liable to pulmonary tuberculosis, and in his physiological entirety is a weakling (see chapter on Macroscelous and Brachyscelous Types).

Anatomical Parts.—Anatomically the thorax is determined in height by the twelve dorsal or thoracic vertebræ, which are characterised by having a transverse apophysis, which articulates with the twelve pairs of ribs, forming the thoracic cage, or chest.

The first seven pairs of ribs articulate in front, by means of cartilages, with the lateral margins of a flat bone, the sternum or breast-bone, which is formed of three pieces: the manubrium uppermost, then the corpus, then, lowest of all, the ensiform (sword-shaped) process.

The manubrium and the corpus form, at their juncture, an angle more or less marked, according to the individual, and the lateral articulation of the second rib corresponds to this angle. In the new-born child the sternum is a cartilage with points of ossification arranged longitudinally like the beads of a rosary. The seventh vertebra articulates laterally at the point at which the ensiform process is attached to the corpus of the sternum. The next three ribs (8th, 9th and 10th) are articulated together and with the seventh by means of cartilaginous arches; the last two pairs of ribs (11th and 12th) are free or floating. At the top, the thoracic cage is reinforced by the thoracic girdle, which serves also to afford articulation for the upper limbs, and which consists of the clavicles, in front, and of the scapulæ, behind. The clavicles are long bones placed in an almost horizontal position above the thorax, and they determine the width of the chest; at the inner extremity they articulate with the manubrium of the sternum and at the outer extremity they are attached to the acromial process of the scapulæ. The scapulæ are flat bones which are attached to the posterior surface of the thoracic frame, on which they are freely movable, covering a tract extending from the second to the seventh rib. At their upper and outer extremity they are provided with two bony processes; namely, the acromion, already mentioned, which contains the points of maximum width of the shoulders, and the coracoid process, which terminates anteriorly and, together with the acromion, overhangs the articulation of the humerus with the body of the scapula.

Powerful muscles clothe the thoracic frame, serving partly in the movements of respiration and partly in the movements of the upper limbs. It may suffice to mention, among the muscles situated posteriorly, the cucullaris, the great dorsal (m. longissimus dorsi), the rhomboids of the scapulæ (m. rhomboideus major and minor), and the serratus posterior of the ribs; anteriorly, the large and small pectoral and the great serratus; beside which there are the intercostal muscles, extending from rib to rib and taking part in the movements of respiration. But the most important muscle is the diaphragm, which completely closes the thoracic cavity, rising into it in a convex vault and separating it from the abdomen; this constitutes the most active of all the muscles which participate in the movements of respiration. The thoracic cavity, thus determined, encloses the two most important viscera of vegetative life—the heart and the lungs.

The heart is a muscle shaped like a pear or cone, having its base turned upward, and its apex or point turned downward and outward toward the left, corresponding to the fifth intercostal space; it is divided, as is well known, into four cavities, and constitutes the great motor power of the circulation of the blood. The lungs are two in number, right and left, and surround the heart, completely filling the thoracic cavity. The lungs are divided into superimposed lobes, three in the right and two in the left lung; they are composed essentially of infinitely small ramifications of the bronchi, resolving into tiny series of chambers, the pulmonary alveoli or air-cells. These alveoli, consisting of a single layer of extremely small cells, are surrounded by a dense network of capillary tubes, through which takes place the interchange of oxygen and carbon dioxide. It has been calculated that if we should estimate and sum up the internal surfaces of the pulmonary alveoli, or, what comes to the same thing, if we should spread out and join together the alveolar walls of the lungs, they would have a superficial area of 200 square metres. This area might be compared to the foliage of a great human tree (respiratory surface).

Physiological and Hygienic Aspect.—The importance of the thorax is physiological, because it contains the highly important viscera of vegetative life; but this importance is especially associated with the lungs. The lungs are the organs that acquire the oxygen from the outside environment, and this oxygen, when taken up by the hemoglobin in the blood, will serve to oxygenate the tissues of the entire organism, and thus aid in the processes of cellular metabolism. A large supply of oxygen stimulates this interchange of matter, not only because the organism as a whole is enriched in the substance essential to this process (oxygen), but because the heart responds to the increased activity of the lungs by more energetic pulsations calculated to set the blood circulating in far greater quantities. It is no exaggeration to say that our whole physiological life is enclosed within the thorax, because the digestive system does nothing more than prepare a blood that is unfitted to irrigate the tissues for the purpose of supplying them with nutriment; it is only after this blood has passed through the lungs that it is transformed into oxygenated blood and is adapted to assimilation. Consequently the intestines prepare nothing more than the raw material, and it is the lungs which perform the service of perfecting it; while the heart drives it through its circuit into contact with all the tissues of the organism.

Whoever has inadequate lungs is for that reason alone a person who necessarily receives insufficient nutriment (thin and weak macroscele), and frequently is also a melancholiac. Melancholia accompanies every form of physiological decadence. On the contrary, persons with ample lungs are generally serene of spirit and joyous. In fact, the emotion of joy is at the same time both the cause and the consequence of an active circulation of oxygenated blood (florid or ruddy complexion).

Certain experiments conducted with birds have proved that if free oxygen is introduced under an air-bell in which the birds have been enclosed, they gradually become more and more excited, singing and fluttering as if possessed by a frenzy of joyousness. It is a fact that we often rid ourselves of a fit of melancholy by taking a walk in the open air; persons possessed of good lungs feel within themselves a vital potentiality that perceptibly aids them to make what we call an "effort of will"; when sorrow befalls them, or overexertion has exhausted their strength, persons of this type feel some force spring up within them that seems to give them fresh hope and courage. It is their oxygenated blood, which neither weariness nor depression of spirit can stay in its luxuriant course; the man of weak lungs, on the contrary, is mentally depressed, because his physiological life has slowed down; and, instead of aiding him, it is his physiological life which demands of him a genuine effort of will to reestablish its equilibrium.

Accordingly, those persons who have a well-developed chest are certainly the healthiest and the happiest.

But this is not the only pulmonary function; the lungs are also the organs of speech. In fact, while speech is manufactured in the brain and the cerebral nerves that stimulate the organs of the spoken word, it requires also its "driving power," that is to say, air, in order to obtain utterance; and it is the lungs to which singers and speakers alike owe the physical strength of their voice. Even the respiratory rhythm has a great influence upon speech.

The spoken word requires a most complicated mechanism, and among the details of this mechanism, by no means the least important are the acts of inspiration, by which the air is received into the lungs, and of expiration, by which it is expelled, simultaneously with all the other movements producing speech. Indeed, we know that when speech is further complicated by the act of singing, it becomes necessary to study special rules for breathing; in short, to educate the voice.

Now, why do we not also educate the voice for its ordinary task of the spoken language? Speech is one of the marvels that characterise man, and also one of the most difficult spontaneous creations that have been accomplished by nature. Through the voice, the lawyer defends the innocent, the teacher educates the new generations, the mother recalls her erring son to the path of virtue, lovers unite their souls, and all humanity interchanges ideas. If intelligence is the triumph of life, the spoken word is the marvellous means by which this intelligence is manifested.

We trouble ourselves to educate the voice only for the purpose of singing, and neglect the spoken word. We do not stop to think that singing appeals only to the senses and emotions, while speech appeals to the emotions and the intellect, and therefore charms and at the same time convinces.

Anyone who has heard that wonderfully gifted speaker, Ofelia Mazzoni, expounding our great poets to the labouring classes at the People's University in Milan, rousing the slumbering intelligence of the working man, will understand what an immense educative force we are neglecting.

In a century in which we speak of an intellectual reawakening and a brotherhood of man, we have forgotten the voice! Yet in this new era of humanity that is learning brotherly love and striving for peace, the voice plays a part analogous to that of the trumpet-call in the centuries consecrated to war.

As a matter of fact, our schools so far neglect defects of speech that it is not uncommon to hear a stammerer undergoing examinations for a degree in jurisprudence. The fact that an otherwise cultured man lisps or stammers is treated by us as quite an indifferent matter, just as among savage tribes a king may have unclean nails without anyone observing the fact.

Yet it is now known that stammering may usually be cured by a systematic training in the art of breathing.

Respiratory gymnastics ought to constitute one of the principal courses of instruction in schools for children. I have introduced it into the "Children's Houses," among children between the ages of four and six, combining it with a special instruction in written language (letters of the alphabet), designed to educate the movements of the organs of speech, without worrying or tiring the children, and this method has borne such good results that our little ones, by the time they are five years old, have lost nearly all their defects in pronunciation.

Spirometry.—The pulmonary capacity may be measured directly by means of an instrument called the spirometer; the breath must be strongly expelled through a tube opening into a hollow cylinder, thus raising a graduated piston contained in it; and, by reading the figure indicated on the piston-rod, we learn the volume of air expelled from the lungs.

Such an instrument is better adapted for use by adults than by children; and if it should ever come to be introduced into the schools, it should not in any case be used below the elementary grades.

The person who is going to measure the capacity of his lungs by means of the spirometer, begins by drawing in an unusually deep or forced inhalation; then, after holding his breath for a moment, he proceeds to expel into the rubber tube all the air in his lungs, in a forced exhalation. In an exercise of this sort, all the difficulties of respiratory gymnastics are successively surmounted—inspiration, respiratory pause, expiration.

In fact, in accomplishing the forced inspiration, all the pulmonary alveoli must be dilated to the maximum extent, and at the same time the thorax must reach its maximum dilation. This is a very different matter from normal inspiration, which does not completely dilate the alveoli. As a matter of fact, the tidal air or air of respiration, i.e., the air taken in and expelled in each normal respiration, is about 500 cubic centimetres; but the sum total of air habitually contained in the lungs is made up of two quantities: first, that which may be emitted by a forced expiration, the supplemental or reserve air, amounting to 1,600 cubic centimetres; and secondly, the air which cannot ever be emitted, because no amount of effort could completely expel all the air from the lungs; residual air or respiratory residuum amounting to 1,200 cubic centimetres. To recapitulate, the average pulmonary capacity is the sum of the following average quantities of air:

Accordingly, the total pulmonary capacity is about 5,000 cubic centimetres, or five litres. But in normal respiration, the capacity is less, i.e., about 3,300 cubic centimetres, the air due to a forced inspiration not being included.

Therefore, in each normal respiration a half litre of pure air (assuming that it is pure) is introduced and mingled with the vitiated air already within the lungs; and since, in expiration, a third only of this 500 cubic centimetres is eliminated, it follows that 166 cubic centimetres are mingled with the 3,300 cubic centimetres; in other words, that only one-tenth of the air is renewed in each normal act of respiration.

A very energetic forced inspiration may draw into the lungs, in addition to the customary 500 cubic centimetres, an additional 1,670 cubic centimetres of pure air, complementary air. In this case the lungs contain upward of 5,000 cubic centimetres of air.

The forced expiration which follows upon this extra deep inhalation purges the lungs of the vitiated air which has formed there. In this way we complete an exercise that is eminently hygienic.

Now, these spirometric movements are fraught with difficulties: 1. The forced inspiration, deep enough to extend the alveoli, may be more or less complete. If a cloth wrung out in cold water is laid across the shoulders, the inspiration which follows as a result of reflex action is far deeper than that produced by an act of will; this proves that the lungs can be dilated to a point beyond that which seems to us to be the extreme limit, and therefore that with practice we may learn to dilate our lungs still further.

2. When the attempt is made to hold the breath after a forced inspiration, almost everyone at the first trials will allow more or less of the air to escape; that is, they will discover themselves incapable of controlling their own organs of respiration; therefore, a gymnastic exercise for acquiring such control is necessary. This is the exercise which will make us masters of the movements required to produce vocal sounds at pleasure.

3. A slow expiration so controlled as to give time for the air to penetrate into the spirometer, is accomplished, though somewhat unevenly, the first few times, and is perfected with practice.

It results from the above that: 1. We take in less air than we are able to take in; 2. part of this air is lost outside the spirometer; consequently the spirometer registers a pulmonary capacity below that which the lungs actually have; and we shall find that, with practice, the volumetric figure will successively augment. But the pulmonary capacity has not augmented in proportion; it is only that practice has perfected the respiratory movements. Accordingly, the spirometer may serve as an instrument to test the progress made in respiratory gymnastics, and, in the case of those who have already become skilful in its use, it becomes a really valuable instrument for measuring the respiratory capacity.

When we remember that a portion of the air, i.e., 1,200 cubic centimetres, never issues from the lungs, it follows that the respiratory capacity is less by 1,200 cubic centimetres than the pulmonary capacity, which, as we have seen, is on an average upward of 5,000 cubic centimetres (5,370) in the adult man. Hence, the spirometer directly measures the respiratory capacity, and only indirectly the pulmonary capacity.

When women measure their lungs by means of the spirometer, they have difficulty in registering 2,000 cubic centimetres, and men have difficulty in attaining 2,600 cubic centimetres. Instead of which, a man ought to be able to register between 3,800 and 4,000 cubic centimetres.

What keeps the lungs healthy is an abundant aeration with air rich in oxygen, and not impure with carbon dioxide and other poisonous gases. When the pulmonary air-cells are insufficiently dilated, they are predisposed to attack by the bacillus of tuberculosis. Indeed, pulmonary tuberculosis usually begins at the apexes of the lungs, which are less thoroughly aerated, and also usually attacks persons with narrow chests. The treatment of tuberculosis is eminently a fresh-air treatment; tuberculous patients may be benefited and even cured in a remarkable percentage of cases (50 per cent.) if they are exposed day and night to the open air. In this way the relation between free respiration and pulmonary health is demonstrated.

In America at the present time the hygienic rule of sleeping at night, winter and summer, with the windows open, is gaining ground, and even the practice of sleeping in the open air. And the various forms of sport also have the beneficial effect of bringing those who indulge in them into a healthy contact with fresh air, which civilised man has shown a fatal tendency to abandon.

The same exercise which dilates the lungs (the contents) also dilates the thorax (the container). The result is that man ends by acquiring the thorax corresponding to his vocation, or in other words, a thorax corresponding to the life that he leads in consequence of the form of work to which he devotes himself. Shepherds in mountain districts and mountain peasants have the largest thorax, notwithstanding, as we have seen, that they are more scantily nourished. In cities, the maximum average circumference of chest is found among the cart-drivers, and the minimum among university students and in general among those who have grown up in an inclosed environment, with the thorax artificially cramped by the position assumed while writing or reading at a desk; yet this is the class of persons who have abundant nutriment.

Consequently, we find a division of air and bread between different social castes; those who have air, do not have bread, and they possess large lungs, out of proportion to bodies which, being underfed, have been unable to grow; and those who have bread do not have air, and they possess lungs that are insufficient for the needs of bodies that have grown under the influence of abundant nutrition. Consequently, all civilised men are physiologically out of equilibrium, and their physical health is lessened. But those who suffer most from this loss of equilibrium are the studious class, who have nourished themselves upon hopes and opened their minds to great ideas, and deluded themselves into undertaking big enterprises; but in real action they find that they are weak, and that they easily fall into discouragement and depression, and when their will-power forces them onward, their organism responds with nervous prostration and melancholia.

It is a sad fact that at the present day the best energies of man reach maturity possessed of insufficient lungs, and consequently liable to break down in health, energy and strength.

A large part of the studious class, such, for instance, as the teachers, are at the present day devoting themselves to a form of work which is not a pulmonary exercise, but pulmonary destruction.

We must remember that healthy exercise of the lungs should take place in the open air, and consists of indrawn breaths deep enough to dilate the air-chambers. Instead of this, the teacher speaks, which means that he makes forced expirations, during many hours in an enclosed environment and in an assemblage of persons who, for the most part, are far from clean. The bacillus of tuberculosis finds in the teacher its favourite camping-ground. In fact, statistics indicate that the maximum mortality from tuberculosis is among teachers; higher even than among nurses. It is really distressing to think of the ignorance of hygiene in which our schools are even yet steeped, so that they seem forgetful of the body, in their pursuit of a spirit that eludes them and that, as a matter of fact, is not being educated in anything approaching a rational manner.

When we enter a class-room, we see rows of benches constructed like orthopedic machines, to the end that the vertical columns of the pupils shall not be distorted during their enforced labour; and the thought arises: this is the spot in which the teacher becomes a consumptive for the sake of transforming the children into hunchbacks. What is the reward of so great a sacrifice? What sort of a preparation in ideals and in character are they giving to the new generations through such disastrous means? What are the obstacles which they are being taught, through so much suffering, to surmount and to conquer? What, in short, is the spiritual gain achieved at the cost of so great an impoverishment of the body?

The answering silence that greets these questions indicates that we have a great mission to accomplish.

Anthropological studies made upon pupils have demonstrated that school-children rarely attain a sufficient chest development. I also have made my modest contribution, proving that the brightest scholars, the prize-winners, etc., who, as a general rule, also enjoy an advantage in social position, have a narrower chest measure. Among the children that are recognised as the brightest in their classes, I have been able to distinguish two categories: those who are exceptionally intelligent, and those who are exceptionally studious; the former have a better chest development than the latter.

Signorina Massa, one of my pupils at the University, in the course of kindred studies made among pupils of a uniform social grade (the poorer classes) observed that the best and brightest scholars, etc., have a chest circumference and a muscular strength notably inferior to the children who are not studious. There can be no doubt that an assiduous application to the study table impoverishes the organism and above all impedes the normal development of the thorax. This fact has a really overwhelming importance. Study the tables of mortality in Italy for infective diseases, i.e., those diseases in which mankind meets the assault of the microscopic invader either with a strong constitution, or with one already predisposed to defeat. The most dreaded diseases, such as diphtheria, typhoid, measles and scarlet fever are all grouped together under a mortality oscillating between five and twenty-five thousand deaths a year. But bronchitis and pneumonia each cause a mortality that ascends to between seventy and eighty thousand deaths; in this group it is evident that we must take into consideration, not only the infected environment, but also the organic predisposition. Every man and woman has been prepared, by their years in school, to have in the form of a narrow chest and an insufficient development of the organs of respiration, a locus minoris resistentiæ. Whoever talks of the war against tuberculosis ought first of all to investigate the school and its pedagogic methods.

Anthropological Aspect. Growth of the Thorax.—In the course of its growth the thorax undergoes an evolution, not only in itself, but also in its relation to the vertebral column.

Fig. 124.

The nature of the transformations undergone by the skeleton of the trunk in relation to its different parts is substantially as follows: in the child at birth the vertebral column is straight, and the thorax is higher up than in the adult; the pelvis, on the contrary, slants forward and downward. In the adult the vertebral column is curved in the form of an S, showing the two-familiar dorsal-lumbar curves, and the axes of the thorax and pelvis are more perceptibly horizontal; in short, in the course of growth a descent of the thorax has taken place, together with a rotation of the pelvis (Fig. 124).

A. Descent of the Thorax.—This is the chief of these characteristics: the thorax descends in the course of its growth.

In the new-born child the upper edge of the manubrium of the sternum is in juxtaposition to the body of the first dorsal vertebra, while in the adult it is situated on a level with the lower edge of the second vertebra.

Even the tendinous arch of the diaphragm has shifted, being lowered by the space of a vertebra; it is situated between the eighth and ninth vertebræ in the child at birth, and between the ninth and tenth in the adult.

The outside characteristics are in correspondence with this fact; the shoulders descend in the course of growth. In the adult, the acromia or points of the shoulders are on a lower level than the incisura or cleft in the sternum (which is visible at the anterior base of the neck, and may be felt as an indented half-moon); while in the new-born child, on the contrary, the shoulders are higher up than the upper extremity of the sternum.

Another external characteristic of the descent of the thorax is the change in position of the nipples at successive ages; the mammary papillæ of the adult correspond to the level of the lower extremity of the sternum, and are situated respectively at the central points of the two halves of the thorax; in the new-born child, on the contrary, the mammary papillæ are further apart and higher up.

Fig. 125.—A = vertex of triangle; B B' = extremities of base, corresponding to the two nipples.

These characteristics of the descent of the thorax are fully established in the period of puberty and are of great importance, since, if not completed, they indicate cases of arrest of development or infantilism.

Quétélet has made a study of the triangulation of the thorax (Fig. 125).

If the two nipples and the sternal incisura are connected by straight lines inclosing an isosceles triangle ABB´, the length of the base in the new-born child is 70 millimetres, and that of the sides BA, B´A is 54 millimetres, and the height 41 millimetres.

In the adult the dimensions are as follows: BB´ = 197 millimetres; AB, AB´= 184 millimetres; and the height = 155 millimetres. Comparing the measurements of the child at birth with those of the adult, we find that the base in the adult is 2.81 times, and the side 3.41 times that of the child; in other words, the sides of the triangle increase far more than the base, and its height in the adult (representing very nearly the entire height of the sternum), is 3.78 times that in the new-born child. Consequently, in the course of its transformation the thorax not only descends, but it is also lengthened in the adult, as compared with the form that it had at birth.

B. Dimensions of Thorax in Relation to Stature.—Besides its descent, there is a second transformation of the thorax, in regard to its volumetric relations to the rest of the body. The perimeter of the thorax and the circumference of the head are pretty nearly equal in the new-born child; if anything, the circumference of the thorax is a trifle less than that of the head; but when it equals it, this is a sign of robustness. In the majority of cases it is not until the second year or thereabouts that the two circumferences become equal. If, however, such inequality should still persist after the child had entered upon the third year, it would constitute a sign of rickets (head too large, chest too narrow).

As to the relations between the thoracic circumference and the stature, it is found that in the child at birth the thoracic circumference exceeds one-half the stature by about 10 centimetres. If the difference is less than 8 centimetres it is a sign of feeble constitution, if it is greater than 10 (for instance, 11 centimetres) it is a sign of great robustness.

This difference disappears little by little; at the age of five years it is already reduced to between 4 and 5 centimetres; at the age of fifteen, the period of puberty, it has wholly disappeared, and the well-known relation between the stature and the circumference of the thorax has become established; the thoracic circumference is equal to one-half the stature (see chapter on Form), and this constitutes Goldstein's vital index:

Vi = (100×Tc)/(S)

As early as 1895, Pagliani published some studies of children, which reveal the physiological importance of the dimensions of the thorax; watching the lives of infants whose measurements he took at the foundling asylum, he observed that the mortality of infants is quite rare when they exceed the above proportions between circumference of chest, head, and stature.

From a study of 452 infants, Fraebelius has drawn the following conclusions:

I. Mortality 21 per cent.; circumference of thorax greater than half the stature by 9.10 centimetres; circumference of thorax less by 1.5 centimetres than perimeter of cranium.

II. Mortality 42.9 per cent.; circumference of thorax greater by 7 centimetres than one-half the stature; circumference of thorax less by 2.8 centimetres than circumference of cranium.

III. Mortality 67.5 per cent.; circumference of thorax greater by 4.5 centimetres than one-half the stature; circumference of thorax less by 4.7 centimetres than the cranial circumference.

The thorax in children of five years and upward ought to be larger by a few centimetres (not more than from 4 to 5) than one-half the stature.

C. Transformations of the Thorax Considered by Itself: Alterations in Shape.

Thoracic Index.—Lastly, the thorax changes its shape in the course of growth. In the new-born child it is very prominent in front, and narrow laterally; in the adult, on the contrary, it is more flattened in its antero-posterior dimension and wider transversely. Consequently the transformation consists in a notable difference in the proportion between the width and depth of the chest, that is, between the antero-posterior and the transverse diameters (see chapter on Technique). This proportion constitutes the thoracic index, which is expressed by the following formula:

Ti = (100A-PD)/TD

and this formula gives an idea of the shape of the thorax.

In the child at birth the antero-posterior diameter is very nearly equal to the transverse; accordingly, the index, at birth, oscillates between 90 and 100.

In the adult, however, the thoracic index is on an average 75; the transverse diameter therefore increases much more than the antero-posterior diameter. According to Quétélet, while the transverse diameter multiplies threefold in the course of its growth, the antero-posterior merely doubles (2.36); in addition to this the thorax also lengthens, as we have already seen.

Proportion, Shape and Dimensions of the Thorax.—In the adult normal man we find the following proportions: The distance between the mammary papillæ is about equal to the antero-posterior diameter of the thorax (hence the papillæ indicate the depth of chest) and is also perceptibly equal to one-half the breadth of the shoulders (measured between the two acromia), which, by the way, is the maximum transverse dimension of the skeleton.

This maximum dimension (the biacromial distance) may be regarded as an index of the skeletal development; and Godin takes its proportion to the transverse thoracic diameter (the horizontal distance between the two vertical lines drawn from the arm-pits, in the plane of the mammary papillæ, see Chapter VII, Technique) in order to estimate the proportional relation between the skeleton and the organs of respiration. Since in the course of growth the thorax broadens, that is, the transverse diameter increases more than the antero-posterior, we should expect to find that in the course of evolution, the difference between the transverse development of the skeleton and the lateral development of the thorax steadily diminishes.

It happens, on the contrary, that from the age of ten years onward, during the whole puberal development, the transverse diameter of the thorax steadily becomes less, as compared with the breadth of the shoulders, so much so that if the difference was at first 97 millimetres, it becomes finally 116 millimetres. According to Godin, this indicates that the thorax does not obey the harmonic laws of the development of the skeleton as a whole, but that, owing to causes of adaptation (the school!) it remains definitely inferior to the development which it might have attained, and consequently results in throwing the organism out of its physiological equilibrium. In fact, if we make men raise their arms, especially men of the student class, a certain hollowness, which is æsthetically displeasing, is revealed along the sides of the thorax. This deficiency is corroborated, according to Godin's studies, by his observation of another correspondence in the measurements of the thorax. In addition to the customary measurements, Godin introduced, besides the well-known and classic thoracic perimeter—which is the circumference taken in the horizontal plane passing through the nipples—two other circumferences: one of them higher up, the subaxillary circumference, which includes a large proportion of the pectoral and dorsal muscles; and the other lower down, the submammary circumference, which determines solely the measurement of the thoracic skeleton, since the intercostal muscles are practically the only ones which descend to this level. These two circumferences are to be considered together, according to Godin, as expressing the relation between the organs of respiration and the muscular mass. In complete repose, the subaxillary circumference is much greater than the submammary; but at the moment of maximum inspiration the latter should become equal to the former; hence, the difference between the submammary circumference in repose and during inspiration furnishes an indirect index of the respiratory capacity, and the subaxillary circumference is a test of individual capacity. Godin notes that inspiration almost never succeeds in attaining an equality between the two circumferences.

Shape of the Thorax.—In regard to the shape, which stands in relation to the thoracic index, it is found to vary according to individual types; in fact the index itself, although showing a mean average of 75, oscillates between the extremes of 65 and 85. As a general rule, the brachycephalic races have a deeper thorax, i.e., having a cross-section of more rounded form; the dolichocephalics, on the contrary, have a more flattened thorax in the antero-posterior direction (these races, such as the negroes, are more predisposed to contract pulmonary tuberculosis). Consequently there is a correspondence in type between the head and the thorax. In the measurements taken by me among the women of Latium the results show that the brachycephalics had an average depth of thorax amounting to 188 millimetres and the dolichocephalics only 181 millimetres, while the transverse diameters were very nearly equal: 241 millimetres in the brachycephalics, and 240 millimetres in the dolichocephalics. Hence, the resultant thoracic index of 78 for the brachycephalics and 75 for the dolichocephalics.

Such differences in the index indicate also differences in the formation of the thorax: that it is more or less flattened in the dolichocephalics, and more prominent in the brachycephalics. There is a corresponding diversity of form in the breasts of the women: the dolichocephalic races have more elongated breasts (pear-shaped), the brachycephalics more rounded.

The shape of the thoracic section is at the present time taken into careful consideration, especially in medicine, because it is apt to reveal predispositions to diseases.

It may be obtained by the aid of the cyrtometer (see chapter on Technique). At the present day, however, exceedingly complicated instruments have been constructed, which, by the aid of recording indexes, give a direct representation of the shape of the thoracic perimeter, together with its modifications and respiratory oscillations.

Since these instruments are, for the present, very far removed from widespread practical use, we may adopt as an excellent method for determining the shape and, at the same time, the dimensions of the thorax, that of Maurel, in his research regarding "the square surface of the thoracic section."

Having determined the anthropometric points, Maurel passes strips of metal (stiff enough to retain the shape given them) around the thorax, after the fashion of a tape-measure, first around one half, and then around the other.

Next he places these metal strips (still retaining the shape given them by contact with the thorax), upon a sheet of especially prepared paper, marked in squares, and traces upon it the inner outline of the strips.

The two halves must be made to coincide in such a manner as to reproduce faithfully the thoracic section, both in form and in dimension.

By adding up the squares contained within the outline we obtain the area of the section.

Fig. 126.

This method is the only really rational method for studying the thorax; and its simplicity, practicality and graphic representation recommend it as a valuable aid to pedagogic anthropology.

There is, for example, an abnormal form of thorax, which I have very often met with in deficient children. It consists in an exaggerated curve of the posterior costal arches, which consequently form a very sharp angle with the vertebral column, which is notably indented, while the sternum is also depressed in a groove, and occupies a plane posterior to that of the ribs. The section of the thorax, in this case, approaches the form of a figure 8; and the thoracic perimeter would not represent the true measurement because it would include the empty spaces left by the front and back depressions. The thoracic index would also give a false idea of the facts, because the antero-posterior diameter would be nowhere so short as at the centres of measurement for this diameter.

The only method for representing the true shape and area of this type of thorax is that employed by Maurel.

Anomalies of Shape.—In addition to the preceding anomaly, very frequent in degenerates, and associated with a deficient development of the lungs and with physical weakness, there are numerous other anomalies. Among others, those that principally deserve attention are the funnel-shaped or consumptive thorax, in which the longitudinal diameter is excessive; the thoracic frame is greatly elongated and the ribs descend to a very low level; this type of thorax is frequent in neuropathic women, and, according to Féré, is associated with degeneration.

The opposite form is the barrel-shaped thorax, in which the prevailing diameter is the antero-posterior; it is very prominent and is frequently met with in persons who are subject to forms of asthma, maladies of the heart, etc.

The bell-shaped thorax is similar to the preceding, but is characterised by an accompanying exceptional brevity of the longitudinal diameter, which causes it to resemble the infantile thorax (arrest of morphological development).

The grooved thorax is the one described above as common among the mentally deficient.

A considerable importance attaches to a form of thorax distinguished by the shortness of the clavicles, in consequence of which the chest remains flat, paralytic or flat thorax (habitus phthisicus). The flattened appearance is due to the fact that the chest cannot rise in front, and the shoulders, being cramped by the shortness of the clavicles, curve forward, while the scapulæ stand out from the plane of the back and spread themselves like wings (scapulæ alatæ). I have met with this form in deficients, accompanied by such laxity of articulations, that it was possible to grasp the points of the shoulders and draw them together until they very nearly met in front.

This form of thorax is characteristically predisposed to pulmonary tuberculosis, and is frequently met with in the macroscelous types.

The commonest deformities of the thorax are those associated with rachitis.

One of the forms regarded as being rachitic in origin is the keel-shaped thorax, in which the sternum is thrust forward and isolated along its median line, like the keel of a boat.

But the thoracic deformities due unquestionably to rickets are of the well-known types that go popularly under the name of hunchback, and are accompanied by curvatures of the vertebral column. The first admonitory symptoms are shown by the so-called rachitic rosary, i.e., by the small swellings due to enlargement of the ends of the ribs at their point of attachment to the sternum. Subsequently, the softened ribs become misshapen in various ways, especially from the fourth rib downward, the upper ribs being fastened and sustained by the thoracic girdle and by the muscles. The curvatures of the vertebral column which accompany rickets are scoliosis or lateral deviation (frequent in school-children) and kyphosis, or deviation in a backward curve; for the most part these two curvatures occur together, so that the vertebral column is thrust outward and at the same time is twisted to one side: kyphoscoliosis.

Pedagogical Considerations.—The following considerations are the natural sequence of what has been said above. Deficiency of the thorax is one of the stigmata left by the school, which in this way tends to make the younger generations feeble and physiologically unbalanced.

The exaggerated importance which is given to the school benches for the purpose of avoiding deformities of the vertebral column deserves to be put aside and forgotten, as an aberration of false hygiene. The bench will not prevent restriction of the thorax; before reaching the critical point which the improved school bench is intended to prevent, many impoverishments of the organism, fatal to robustness and health, and often to life itself (predisposition to tuberculosis!) have been incurred; and there is no other remedy to obviate them than a reform in pedagogic methods. The admonitory fact that neglected, despised, half-starved children have an enormous advantage in the development of the thorax over the more intelligent children who are well-fed and carefully guarded, and solely because the former are free to run the streets, ought to point the direction in which we should look for means of helping the new generations hygienically. They have need of free movement and of air. The recreation rooms which tend to keep the children of the street shut up indoors even during recess are taking from the children of the people the sole advantage that still remained to them. Try to realize that these children are obliged to sleep in dark, crowded environments, and that every night, during the period of sleep, they suffer from such acute poisoning by carbon dioxide that they frequently awaken in the morning with severe pains in the head. The life of the streets is their salvation. We condemn children to death, under the delusion that we are working for their moral good; a perverted human soul may be led back to righteousness; but a consumptive chest can never again become robust. Let those who talk of education and morality and similar themes be sure that they are benefactors and not executioners, and let those who wish to do good seek the light of science.

Curvatures of the vertebral column, such as lordosis and kyphosis, cannot be considered solely in relation to the thorax, but in relation to the pelvis as well, because, especially in lordosis, the lumbar vertebræ are also involved, while the pelvis also suffers a characteristic deformity.

CHAPTER IV
THE PELVIS

Anatomical Note.—The five lumbar, the five sacral and the four coccygeal vertebræ constitute the lumbar and sacro-coccygeal section of the vertebral column.

Fig. 127.—Skeleton of Pelvis, Seen from Above.

The sacrum, formed by the union of the five sacral vertebræ, appears in the adult in the form of a bone that narrows rapidly from above downward in a general curve whose convex side is turned inward. The coccyx has the importance of being a real and actual caudal appendage, reduced in man to its simplest anatomical expression. On each side of the sacrum the two ossa innominata or hip-bones are attached, constituting a sort of massive girdle (cintura pelvica), serving as point of attachment for the lower limbs, while at the same time it sustains the entire weight of the body and the abdominal viscera. These two bones are made up of three separate parts: an upper part, very broad and rather thin (the ilium, which constitutes the flank or hip), one in front (the os pubis), and a third behind, quite massive, and shaped like the letter V (the ischium). The two ossa innominata and the os sacrum form the pelvis or pelvic basin, a broad cavity with bony walls that are by no means complete, within which are a portion of the digestive organs and a considerable part of the organs belonging to the genito-urinary system. The pelvis supports the vertebral column and is in turn supported by the lower limbs, in quite marvellous equilibrium.

The maximum sexual differences of the skeleton are in relation to the pelvis; in woman the iliac bones form a far ampler basin; in man, the pelvis is higher and more confined and formed of more solid bones; but it is not broader. But where the difference is most apparent is in the pelvic aperture (see Fig. 127) which divides the pelvis into two parts, the upper or great pelvis and the lower or small pelvis. This aperture has distinguishing marks that differ widely between the sexes; in woman it is rounder, in man it is more elongated from front to back and is narrowed toward the pubis. One of the most important points of measurement in anthropology and in obstetrics is the extreme anterior apex of the superior border of the ilium or crista iliaca antero-superior. The woman in whom this dimension (the bis-iliac) is less than 250 millimetres cannot give birth naturally; similarly the woman who has a prominent os pubis (due to rachitis) will owe the attainment of maternity to the intervention of surgery, and perhaps even of the Cæsarean operation.

There are also many ethnical differences in the pelvis: brachycephalics (the mongolian race) have a broader and shallower pelvis than the dolichocephalics, who, on the contrary, have a deeper and narrower pelvis (the negroes). The same thing is met with, notwithstanding its intermixture, in our own race: blond, brachycephalic women have a wider pelvis than brunette, dolichocephalic women.

Accordingly, cranium, thorax and pelvis correspond in one and the same ethnic type.

The abdomen extends from the arch of the diaphragm to the lower extremity of the pelvis. It contains all the viscera of alimentation: the digestive system together with the glands belonging to it; the liver and pancreas, besides the renal system and, in women, the organs of generation (uterus and ovaries). The diaphragmatic arch, having its convex side uppermost, enters the thoracic frame as far as the first dorsal vertebra. The intestinal mass is more noticeable and prominent in persons having a narrow pelvis; in children, for example, the abdomen is very prominent.

Growth of the Pelvis.—In the skeleton of the new-born child the pelvis differs from that of the adult in two particulars: height and direction. The pelvis is low in the new-born child and higher in the adult. The central axis is more oblique from front to back (in the higher mammals the axis of the pelvis is almost central); in the adult, on the contrary, this axis tends to straighten up, to the point of becoming nearly vertical, in relation, that is, to the erect position of man. Hence in the course of growth the pelvis not only becomes proportionally higher, but it undergoes a rotary movement around the cotyloid axis; this movement has the effect of elevating the pubis and bringing the ischium forward.

Fig. 128.

The vertebral column rests upon the sacrum, which is the retro-cotyloid portion of the pelvis, and its pressure tends mechanically to straighten the pelvis (see diagram, Fig. 128). This process of straightening has certain limits, and is dependent upon the form of curvature of the vertebral column; if this is exaggerated, as in lordosis, the weight is thrown further forward, almost over the cotyles; consequently, the elevation of the pelvis is not properly accomplished (low pelvis found in lordotics). If, on the contrary, the lumbar curvature is wanting or reversed (kyphosis), the pressure of the column is thrown backward and the straightening up of the pelvis is exaggerated (high pelvis found in kyphotics). Independently of pathological deformities, there are various forms of lumbar curvature in the vertebral column that are normal oscillations, or oscillations acquired through adaptation.

An exaggerated lumbar curvature or saddle-back is found in children accustomed to carry heavy loads upon their shoulders; a diminished curvature is found in children constrained to remain in a sitting posture for many hours a day. The sitting posture tends to cancel the lumbar inward curve; consequently, while children are in school they are promoting the elevation of their pelvis.

The elevation of the pelvis proceeds rapidly at the fifteenth year, during puberty, when the muscular masses become more solid.

A woman is not fitted for motherhood, even if physically developed, so long as her pelvis has not rotated normally. But if the rotation is exaggerated (due to prolonged sitting posture during years of growth), this is very unfavourable to normal childbirth. In rickets, associated with kyphosis, there is a form of exaggerated rotated pelvis (pubis high). The laborious "modern" childbirth, and the dangerous childbirth in the case of women who have devoted much time to study, must be considered in connection with these artificial anomalies. Free movement and gymnastics have for this reason, in the case of women, an importance that extends from the individual to the species.

CHAPTER V
THE LIMBS

The study of the limbs is of great importance, because, although it is the special province of the bust to contain the organs of vegetative life, it is the limbs which render it useful. In fact, it is the lower limbs which control our locomotion and the upper limbs which execute the labour of mankind.

One characteristic of man, equally with that of standing in an erect position, supported only on the lower limbs, is the independence of the upper limbs, which are raised from the ground and relieved of the function of locomotion—a function that still continues in all other mammals, excepting the anthropoid apes, whose upper limbs are extremely long and barely escape the earth, and serve the animal merely as an aid and a support in walking. The birds, although supported on their hind limbs alone, nevertheless have their fore limbs assigned to the sole office of wings for the transportation of their bodies.

Consequently, the free and disposable upper limb, peculiar to mankind, would seem to mark a new function in the biologic scale—human labour.

Anatomy of the Skeleton of the Limbs.—In contrast to the bust, the limbs have an internal skeleton, adapted solely to the function of support (not of protection). The bones are covered with masses of striped muscles, which have as their special function voluntary movement, that is to say, obedience to the brain.

The upper and lower limbs correspond numerically, and the arrangement of the bones is analogous; and this holds true for all the higher vertebrates. The nearest bones, those that are attached to the trunk, are single in all four limbs. Then, just as though branching out, they next double in number, and then multiply successively as we approach the extremities of the limbs. Thus the forearm and the lower leg have two bones, and the hands and feet have many.

In the upper arm we have the humerus, in the thigh the femur, in the forearm the ulna and radius (the ulna is situated on the same side as the little finger and the radius on that of the thumb), in the lower leg the tibia and fibula. Then come the many short bones (eight in the carpus and seven in the tarsus) which in the hand form the wrist or carpus, and in the foot the ankle or instep, the tarsus. These are followed by other long bones (five in the hand and five in the foot), which constitute the metacarpus and metatarsus, and these in turn by the long bones of the phalanges (fingers and toes), which grow successively smaller toward the extremities and are successively named proximal, middle and distal phalanges (phalangettes). These last are missing in the thumb and the big toe. In conjunction with the last phalanges, the fingers and toes are protected by nails.

The Growth of the Limbs.—Recent studies, conducted principally by Godin in France, author of the classic work upon growth, have demonstrated that the long bones of the limbs obey certain special laws of biologic growth.

While a long bone is growing in length it does not grow in width or thickness, and while it is increasing in thickness it does not gain in length; hence the lengthening of the bones takes place in alternate periods; during the period of repose relative to growth in length, the bone gains in thickness.

I have already explained, in connection with the stature, that we owe the growth of the long bones to a variety of formative elements, the cartilages of the epiphyses, which control the growth in length of the long bones, and the enveloping membrane of the body of the bone, the periosteum, which presides over the growth in thickness.

The above mentioned alternation in the growth of the bones must therefore be attributed to an alternation in the action of these various formative elements of the bones.

In the case of two successive long bones (for example, the humerus and radius, the femur and tibia, the metacarpus and phalanges, etc.), they alternate in their growth; while one of them is lengthening, the other is thickening; consequently the growth of a limb in length is not simultaneous in all the bones, but takes place alternately in the successive bones. During the time when the growth devolves upon the longest bone, the limbs show the greatest rate of increase in length, and when, on the contrary, it devolves upon the shortest bone, the growth is less; but in either case it continues to grow.

The growth of the long bones of the limbs proceeds by alternate periods of activity and repose, which succeed each other regularly.

These periods of activity and repose occur inversely in each two successive bones.

The periods of repose from growth in length are utilised for gain in thickness, and reciprocally. The long bones lengthen and thicken alternately, and not simultaneously.

It is only at the age of puberty (fifteenth year) that a complete simultaneity of growth takes place, after which epoch the growth in stature and length of limb diminishes, yielding precedence to that of the vertebral column.

When the complete development of the bodily proportions is attained (eighteenth year), the length of the lower limbs is equal to one-half the stature.

When the upper limbs are extended vertically along the sides of the body, the tip of the middle finger reaches the middle point of the thigh, while the wrist coincides with the ischium (hip-bone). The total spread of the arms is, on an average, equal in length to the stature.

The proportions between the lower limbs and the bust, resulting from the attainment of complete individual development, determine the types of stature: macroscelia and brachyscelia. Since the order of growth as between the two essential portions of stature is now determined, we are able to interpret macroscelia as a phenomenon of infantilism (arrested development of the bust).

Malformations. Excessive Development of the Nearer and Remoter Segments.—But there are other proportions that are of interest to us, within the limbs themselves. Even between the nearer and remoter portions of the limbs there ought to be certain constant relations (indices) that constitute differential characteristics between the various human races and between man and the ape. If the humerus or upper arm is taken as equal to 100, the radius or forearm is equal to 73 in the European, while in the negro it is equal to about 80. Furthermore, it is a well-known fact that excessive length of the forearm is an ape-like characteristic.

Consequently, the measurement of the segments of the limbs is important, and it is made with a special form of calipers; when the index of the segments deviates from the accepted normal figure, this constitutes a serious anomaly, frequently found in degenerates, and it often happens that an excessive development of the remoter segments, the bones of the extremities, explains the excess of the total spread of the arms over the stature, unassociated with the macroscelous type.

Absence of Calf.—In addition to this fundamental deviation from normality, there are other malformations worthy of note that may occur in the limbs. Such, for example, is a deficiency or absence of the calf of the leg. The well-turned leg, which we admire as an element of beauty is a distinctive human trait most conspicuous among the races that we regard as superior. Among the more debased negro races the leg is spindling and without any calf; furthermore, it is well known that monkeys have no calves, and still less do they exist among the lower orders of mammals.

Flat Feet.—Another important malformation relates to the morphology of the feet. Everyone knows the distinctive curve or arch of the foot, and the characteristic imprint which it consequently leaves on the ground. Sometimes, however, this arch is missing, and the sole of the foot is all on the same plane (flat foot). The dark-skinned natives of Australia have flat feet as one of their racial characteristics; in our own race it constitutes an anomaly that is frequent among degenerates. Flat feet may also be acquired as the result of certain employments (butler, door-keeper, etc.), which compel certain individuals to remain much of the time on foot. But in such cases the deformity is accompanied by a pathological condition (neuralgic symptoms and local myalgia). Like all malformations, this may have special importance in connection with infantile hygiene (the position of the pupil, the work done by the children, etc.).

Opposable Big Toe.—Another malformation combined with a functional anomaly, that is never met with as a deformity resulting from adaptation, is the opposable big toe. Sometimes the big toe is greatly developed and slightly curved toward the other toes, and capable of such movement as to give it a slight degree of opposability; hence the foot is prehensile. This characteristic, regularly present in monkeys, is so far developed in certain degenerates as to make it possible for them to perform work with their feet (knitting stockings, picking up objects, etc.); so that this class of degenerates, who are essentially parasites, solve the problem of supporting themselves by trading on the curiosity of the public, so that, by straining a point, we might bestow upon them the title of foot labourers.

Loose and Stiff Joints.—Anomalies may also occur in connection with the articulation of the joints. It sometimes happens that they are extremely loose and weak, and allow the bones an excessive play of movement; and, if the lower limbs are thus affected, it increases the difficulty of maintaining equilibrium when standing erect or walking. On the other hand, it may happen that the articulations are too stiff, and consequently render many movements difficult, especially if through an anomalous development of the outer coating of the bone, it results in congenital ankylosis.

Curvature of the Legs.—A special importance attaches to certain alterations undergone by the heads of the bones which contribute to the formation of the knee, because of the curvature of the leg which results from them (rachitis, paralysis). The leg may become bowed outward or inward; when it is bowed inward (knock-knees, genu valgum), the knees strike together in walking; when, on the contrary, it is bowed outward, the result is bow-legs (genu varum), known popularly in Italy as "legs of Hercules," a deformity which in a mild degree may also result from the practice of horse-back riding.

Club-foot (Talipes).—Other deviations from the normal position occur in connection with the foot. Certain paralytic children (Little's disease) walk on the fore part of the foot (talipes equinus, "horse's foot"); in some cases the foot is also turned inward, and consequently such children cross their legs as they walk (talipes equino-varus).

The Hand

Chiromancy and Physiognomy. The Hand in Figurative Speech. The High and Low Type of Hand.—The hand is in the highest degree a human characteristic. It is man's organ of grasp and of the sense of touch, while in animals these two functions are relegated to the mouth. The hand has always claimed the attention not only of scientists but of all mankind without distinction. Attempts have been made to discover the secrets of human personality from the hand, and a whole art has been built up, called chiromancy, which endeavours to read from the hand man's destiny and psychic personality, just as physiognomy was the art of interpreting the character from the face.

Chiromancy was an accredited art as far back as the days of ancient Greece, and it also had a great vogue in the middle ages; while to-day it is out of date and superseded, or perhaps is destined to rise again in some new form, just as physiognomy has risen again in the study of "expressions" of the face and the imprints which they leave behind them. Scientists also have made the hand the object of their careful consideration; and the result of their researches shows that the hand really does contain individual characteristics that are not only interesting but, up to a certain point, are revelations of personality. A written word, a clasp of the hand, may furnish documents for the study of the individual. Graphology, for instance, is naturally related to the functional action and to the characteristics of the hand itself. Gina Lombroso has recently made a study of the hand-clasp in its relation to character; when a haughty person offers his hand, he has the appearance of wishing to thrust you from him; the miser barely offers the tips of his fingers; the timid man yields a moist and chilly hand to your touch; the loyal friend makes you feel the whole vigor of his hand in its cordial pressure.

In the gesture we have an individual form of linguistic expression. Consequently, man reveals himself, not alone through his creative part, the head, but also through its obedient servant, the hand. "The hand is gesture, gesture is visible speech, speech is the soul, the soul is man, the soul of man is in the hand."

Furthermore, we can judge from the hand whether a man is fitted for work or not; and it is to work that the hand owes its human importance. The first traces of mankind upon earth are not remains of skeletons, but remains of work—the splintered stone. The whole history of social evolution might be called the history of the hand. To say that the hand is the servant of the intelligence is to express the truth in too restricted a way, because the intelligence is nourished and developed through the products of the hand, as by degrees the work of the latter transformed the environment. Hence, the history of our intellectual development, like that of our civilization, is based upon the creative work evolved by the collaboration of hand and head. And so, in the orphan asylums, we have the children sing the hymn to the hand, which is a hymn to labour and to progress:

All the solemn acts of life require the cooperation and sanction of the hand. We take oath with the hand; marriage is performed by uniting the hands of the bridal pair; in proof of friendship or to seal a compact, we clasp hands. The word hand has come to be often used in a symbolic sense in many expressive phrases possessing a social and moral significance: "Take heed that the hand of the Lord does not fall upon you;" "Pilate washed his hands;" "to put oneself into another's hands;" "to have a lavish hand;" "to sit with idle hands" or "with the hands in the pockets;" "one hand washes the other;" "to have a hand in the pie;" "to turn one's hand to something;" "to lend a final hand;" "to speak with the hand on the heart;" "to believe the evidence of one's hands," etc.

And this high and symbolic significance given to the hand dates back even to bible times:

Solomon says: "The length of days is in her right hand; and in her left hand riches and honour" (Prov. 3, 16).

And Moses: "Therefore shall ye lay up these my words in your soul and bind them for a sign upon your hand" (Deut. 11, 18).

Attempts have recently been made to describe the "psychological types" of the human hand. Zimmermann, for instance, studies two types of hand: the high type, delicate, small, slender, with rounded, tapering fingers, and convex nails; a hand which would indicate a fine sensibility, delicate and refined sentiments, a well balanced mind, a high degree of intelligence, a strong and noble character. And there is the low type, coarse, short and stocky, with thick fingers and flat nails; an index of sluggish sensibilities, vulgar sentiments and a low order of intelligence, a weak will and apathetic character.

In accordance with the theories of mechanics, the type of hand has been considered in relation to its organic use and morphological adaptation. In general, the hand used in the coarser forms of work is of the low type; the high type of hand is that required for nimble and fine movements, in which there is need of the successive concurrence of all those delicate little groups of muscles which are able to act independently and thus give to this organ the marvelous and subtle variety of movements which distinguish it. In regard to dimensions, the large, heavy hand would betoken use, and the little hand disuse. Therefore, the small hand may be considered as a stigma of parasitism, a distinction which at the present day has lost its nobility. Excepting in so far as the "brain workers," who make themselves useful without employing their hands, may still show a distinctive smallness of these members.

We should not, however, adhere solely either to the psychological theory of the hand, or to the theory of adaptation; it is necessary to consider the characteristics of the hand from several different points of view.

Dimensions.—The dimensions of the hand bear a constant relation to the stature and to certain partial dimensions of the body, while the various parts of the hand preserve constant reciprocal proportions.

As far back as in the time of Vitruvius it was known that the human hand is related to the stature in the proportion of 10 to 100. This is a very important fact to know, because the proportion varies in the inferior races and in the anthropoid apes, the descent in the scale showing a corresponding increase of length of hand relatively to the stature. Thus, for example, in the Mongolian races the proportional length of the hand is 12.50, and in the higher apes it equals 18. Consequently too long a hand is in itself an anomaly that indicates a low type of man; it is to be classed with those anomalies that were formerly regarded as atavistic reversions, phenomena of absolute retrogression in the biological scale.

Relations between the Hand and the other Dimensions of the Body.—The closed fist, taking the extreme outside measurement between the metacarpophalangeal articulations, corresponds to the breadth of the heart.

The length of the hand corresponds to the height of the visage, and also to the distance intervening between the sternal incisura and the auricular foramen; it is also equal to the distance between the two nipples, and therefore also corresponds to the depth of the chest.

There may be hands which are either excessively large or much too small, and that are really marks of degeneration. An excessive volume of these members is called megalomelia, and an excessive smallness oligomelia.

We may encounter an extremely small hand quite as often in the son of an alcoholic labourer as in the son of a degenerate aristocrat; frequently men whose parents were mentally deficient have small, delicate, almost effeminate hands.

The Proportions between the Various Segments of the Hands.—The length of the middle finger, measured from the digito-palmar plica or fold, ought to equal the length of the palm.

Hence the index of the palm should be the proportion between the length of the palm itself and the length of the middle finger. This proportion is of importance because it has certain human characteristics; as a matter of fact, in the anthropoid apes the metacarpus is much longer than the fingers and the palm has a far lower index than that of man. In degenerates (thieves) the hand is frequently narrow and long.

The Proportions of the Fingers.—If the first and second articulations of the fingers are flexed, leaving the third extended, we find that the extremity of the middle finger reaches to the point where the thenar and hypothenar eminences (fleshy prominences at base of palm) are nearest to each other.

This basic point is only approximate and serves to tell us whether the middle finger is normal. The middle finger serves as a measure for the others, as follows:

• The index-finger reaches to the base of the nail of the middle finger.
• The thumb, to the middle of the first phalanx of the middle finger.
• The ring finger, to the middle of the nail of the middle finger.[47]
• The little finger, to the third articulation of the ring finger.

It often happens that the development of the ulnar side of the hand—the little finger, or both little and ring finger together—is defective. Sometimes the little finger is not only extremely small, but a special malformation renders it shorter still when the hand is open; the second phalanx remains flexed, and cannot be extended. Combined with the shortness of such fingers there is also an extreme slenderness—cubital oligodactylia. It is a far rarer thing to find similar anomalies in the case of the index-finger. The thumb, on the contrary, is sometimes extremely short, in consequence of which it has slight opposability.

Functional Characteristics.—What characterises the functional action of the human hand is the opposability of the thumb. There ought to be a perfect movement of opposability of the thumb in respect to all the other fingers; but many imbecile children accomplish this movement imperfectly. The mobility of the thumb is associated with a group of muscles situated at its base which forms the great tenar eminence of the palm, opposite which, in corresponding relation to the little finger is the small hypothenar eminence. An insufficient development of these palmar eminences represents a serious malformation, which entails functional disturbances. The hand of the monkey is flat.

The Nails.—We have already seen that in the high type of hand the nails should be convex and long, and that in the low type, on the contrary, they are short and flat.

The normal nail should extend to an even level with the fingertip. Manual labour should normally serve the purpose of keeping the nails worn down; but we, who are not hand-labourers, must use the scissors, in order to maintain the normal state.

For, if they were not worn down, the nails would attain an enormous length, like the nails of certain kings of savage tribes, who as a badge of authority have such long nails that their hands are necessarily kept motionless; these kings must in consequence be waited on, even for the smallest need, and actually become the slaves of their own nails, which might be shattered by any sudden movement on the part of their royal possessor. Long nails, therefore, are a sign of idleness, while at the same time they demand a great deal of attention. Accordingly, let us repudiate the fashion of long nails.

As a form of anomaly, we sometimes meet with nails of such exaggerated length that they have the aspect of claws—onychogryposis; or, again, an almost total absence of nails, which are reduced to a narrow transverse strip—this characteristic is often found in idiots, and is aggravated by the fact that from childhood such persons have had the habit of "biting their nails."

Sometimes the nails are exceedingly dense, or actually consist of several superimposed layers, so rich in pigment that they lose their characteristic transparency.

This condition is due to trophic disorders of the nails.

Teratology and Various Anomalies.—There are certain monstrosities that sometimes occur in connection with the hand, such as hexadactylism and polydactylism, or hands with six or more fingers; or else hands with less than five fingers—syndactylism. There may even be a congenital absence of a phalanx, with a consequent notable shortness of the finger—brachydactylism.

Another sort of anomaly frequently found in deficients consists of an excessive development of the interdigital membrane, to the extent of giving the hand the appearance of being web-fingered. An anomaly of minor importance consists in a distortion of the fingers; the little finger has one of its phalanges turned backward. All the fingers ought to be in contact throughout their whole length, and not leave open spaces between them.

Lines of the Palms.—The lines of the palms, which used to be of so much importance in chiromancy, are now taken into consideration even in anthropology, being studied in normal and abnormal man, and also in the hands of monkeys. The lines of the palms are three in number. The one which follows the curve of the tenar eminence is known in chiromancy as the line of life, and, if long, deep and unbroken, was supposed to denote good health and the prospect of a long life; in anthropology it is called the biological line. The second crease, which ought to meet the former between the thumb and the index-finger, is the line of the head, or cephalic line, and in chiromancy its union with the line of life was supposed to denote a well-balanced character.

The line highest up, which begins between the index- and middle finger and extends to the extreme margin of the palm, is the line of the heart or the cardiac line, which in chiromancy is supposed to indicate the emotional development of the individual. These lines taken together form a semblance of the letter M, and are characteristically and gracefully curved. It is considered as an anomaly, to be met with among degenerates and even in mongoloid idiots, to lack any of these lines (numerical reduction) or to have their arrangement distinctly horizontal, and reminiscent of the hand of the monkey.

If we trace backward in the zoological scale, we find as a matter of fact that to begin with, there were no lines in the palms, and then there appeared a single crease high up, such as we still find in the Cebus. In the human hand Carrara has recently made a study of these anomalies, distinguishing several types. In the first type there is a single transverse furrow. In the second type there are two furrows which, however, follow a definitely straight and horizontal direction and consequently are parallel. In a third type a single transverse furrow is associated with a very deep longitudinal furrow running from the carpus to the base of the index- and middle finger—a form that Carrara has found only in criminals. Nevertheless, many idiots exhibit a similar longitudinal furrow, due to a peculiar development of the palmar aponeurosis.